Supervisors info:
Μαρία Μοσχόβη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παντελής Περδικάρης, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΠΠ
Ιωάννης Κουτελέκος, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Summary:
Osteosarcoma is the most common bone malignancy in children. Survival of patients with osteosarcoma after surgical resection as monotherapy was only 10%, a rate that improved significantly to 70% after the introduction of chemotherapeutic agents. Chemotherapy presents several advantages but also complications and late effects. In order to design a treatment protocol, the adverse prognostic factors of the disease are taken into account, among them the osteosarcoma necrosis rate. From the recent literature, there are no studies that correlate patient survival with the rate of tumor necrosis after preoperative chemotherapy, as applied in modern treatment protocols. The purpose of our study is to assess the survival of children with osteosarcoma who received preoperative chemotherapy according to the tumor necrosis rate. A retrospective serial study (cohort study) of all patients with osteosarcoma diagnosed from 1997 to 2018, at the Hematology-Oncology Unit of the First Department of Pediatrics of the National and Kapodistrian University of Athens, Children's Oncology Unit "Marianna B. Vardinogiannis-Elpida", Children's Hospital "Agia Sophia" and the Oncology Department of Children's Hospital "Panagiotis and Aglaia Kyriakou", had received pre-operative chemotherapy followed by excision of the tumor with histological assessment of the tumor necrosis rate. In our sample, most children were boys (53.7%), mean age was 12.5 years, mean height 157.57 cm and mean weight 46.18 kg, with elevated lactate dehydrogenase (LDH). The 64.7% of the children lived in the countryside. It was observed that children with a high necrosis rate (≥90%) of the tumor after preoperative chemotherapy had higher survival rates compared to children who had a low necrosis rate (<90%). Children with a good tumor response (≥90% necrosis) to preoperative chemotherapy had an 83% reduced risk of death (p<0.05). It makes the rate of tumor necrosis a strong prognostic factor. Sex, age, race, height, weight, and LDH had no statistically significant association with survival. New treatment options may affect both tumor necrosis rate and patient survival. Therefore, new studies are needed to optimize the selection criteria of the appropriate therapeutic approach.
Keywords:
Osteosarcoma, Children, Tumor necrosis, Survival
